National Provider Identifier [NPI]: |
1205095528 |
Last Name Of The Provider |
BUCHANAN |
First Name Of The Provider |
AMY |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1211 W ROOSEVELT RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MAYWOOD |
Zip Code Of The Provider |
601534046 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
13 |
Number Of Services |
504 |
Number Of Medicare Beneficiaries |
205 |
Total Submitted Charge Amount |
89073 |
Total Medicare Allowed Amount |
38145.86 |
Total Medicare Payment Amount |
26151.06 |
Total Medicare Standardized Payment Amount |
24576.87 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
13 |
Number Of Medical Services |
504 |
Number Of Medicare Beneficiaries With Medical Services |
205 |
Total Medical Submitted Charge Amount |
89073 |
Total Medical Medicare Allowed Amount |
38145.86 |
Total Medical Medicare Payment Amount |
26151.06 |
Total Medical Medicare Standardized Payment Amount |
24576.87 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
92 |
Number Of Beneficiaries Age 75 to 84 |
45 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
167 |
Number Of Male Beneficiaries |
38 |
Number Of Non Hispanic White Beneficiaries |
50 |
Number Of Black or African American Beneficiaries |
104 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
118 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
87 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.3999 |